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Register a new userCausative agents of Onychomycosis in patients seen in Dermatology and Venereal Diseases Hospital in Damascus
العوامل المسببة للفطار الظفري عند المرضى المراجعين في مشفى الأمراض الجلدية و الزهرية في دمشق
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خلفية البحث و هدفه: الفطار الظفري مرض أظافر شائع ينتج عن الفطور الجلدية و الخمائر و الخيوط العفنة غير الجلدية، و لا تعد الأظافر المخموجة فقط مشكلة جمالية، و إنما تشكل خازناً مزمناً يمكن أن يسبب أخماجاً فطرية متكررة. هدفت الدراسة إلى تحديد أكثر الأنواع الفطرية شيوعاً المسؤولة عن الفطار الظفري عند المشتبه بإصابتهم به سريرياً في مشفى الأمراض الجلدية و الزهرية في دمشق بين شهر تشرين الأول من عام 2010 و شهر تموز من عام 2011. مواد البحث و طرائقه: أجري فحص مباشر و زرع للعينة الظفرية لتحديد العامل الفطري المسبب للفطار الظفري. النتائج: كان الزرع إيجابياً في 65 عينة من أصل 76 عينة مشكوك بها سريرياً، و كانت نسبة العوامل الفطرية المسببة: ( 61.9 %) من الفطور الجلدية، و ( 24.6 %) من الخمائر، و ( 13.9 %) من الخيوط الرمية غير الجلدية. كانت معظم الفطور الجلدية المعزولة من نوع الشعروي الأحمر بنسبة ( 43.1 %) يليها الشعروي الفوتي بنسبة ( 16.5%), أما الشعروي البقري فكان بنسبة ( 1.5 %)، و كانت الرشاشيات متعددة الألوان أشيع الخيوط غير الجلدية المعزولة . لوحظ أن إصابة أظافر اليدين أكثر شيوعاً عند الإناث في حين إصابة أظافر القدمين أكثر شيوعاً عند الذكور. و في كلا الجنسين معظم المصابين بين ( 20-40 ) سنة. الاستنتاج: كانت الفطور الجلدية أكثر العوامل المسببة للفطار الظفري شيوعاً عند المرضى المراجعين في مشفىى الأمراض الجلدية و الزهرية في دمشق، و بشكل خاص الفطر الشعروي الأحمر و الفطر الشعروي الفوتي، و أيضاً كانت الخمائر معزولة بشكل شائع نسبياً، في حين كانت الخيوط غير الجلدية غير شائعة.
Background& Objective: Onychomycosis is a frequent nail disease caused by dermatophytes, yeasts, and non-dermatophyte molds. Far more than being a simple cosmetic problem, infected nail serves as a chronic reservoir, which can give rise to repeated mycotic infections. This study aim to identify the common fungal species which are responsible for onychomycosis in clinically suspected patients of onychomycosis in Dermatology and Venereal Diseases Hospital in Damascus between October 2010 and July 2011. Materials & Methods: Both direct microscopy and culture of the nail material were performed to identify the causative fungi of onychomycosis. Results: Culture positivity was obtained in 65 of the 76 clinically suspected samples, etiological fungal agents were (%61.5) dermatophytes, (24.6%) yeasts, and (13.9 %) non-dermatophyte molds . The isolated fungal species were (43.1%) Trichophyton Rubrum and (16.9%) T. Interdigitale (1.5%) T.Verrucosum Aspergillus Versicolor which was the most frequent non dermatophyte molds. Females were affected in fingernails more frequently than males, while males were affected in toenails more frequently than females, and in both sexes those most infected were between 20-40 years of age. Conclusion: Dermatophytes, in particular T. rubrum, but also T. Interdigitale, are the most frequently isolated causative agents in onychomycosis in patients seen in Dermatology and Venereal Diseases Hospital in Damascus . In addition, yeasts may be isolated relatively frequently, while molds are uncommon.
References used
Welsh O, Vera-Cabrera L, Welsh E. Onychomycosis, Clin Dermatol. 2010 Mar 4;28(2):151-9
Goettmann-Bonvallot S,Clinical types of onychomycosis, Ann Dermatol Venereol. 2003 Dec;130(12 Pt 2):1237-43
Antonella Tosti, Clinical Presentation:Onychomycosis, emedicine.medscape,5 May 2010, 1105828-overview
Hylton Menz ,Foot Problems in Older People .Assessment and Management , Nail disorders,2008 page 100- 102
Neupane S, Pokhrel DB, Pokhrel BM. Onychomycosis: a clinico-epidemiological study. Dermatol. 2009 Jul;36(7):410-4
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